First-trimester biomarkers for early prediction of gestational diabetes mellitus: a meta-analysis

Gestational diabetes mellitus (GDM) occurs in approximately 7% of all pregnant women. In order to minimize the risk of GDM-associated complications, it is still very important to identify novel biomarkers for early prediction of GDM, particularly in the first trimester. In this study, we conducted a meta-analysis to assess the clinical implications of first-trimester biomarkers, including sex hormone-binding globulin (SHBG), adiponectin and C-reactive protein (CRP), in predicting the risk of GDM. Electronic databases, including Medline, Embase, Scopus, Google Scholar, and Cochrane Library, were searched and fourteen studies including 2479 patients were identified for this meta-analysis. The random-effects model was employed to pool the data from the included studies to determine the difference in the first-trimester serum levels of SHBG, adiponectin, or CRP between patients with GDM and normal pregnancies. Our meta-analysis reveals that GDM patients exhibit significantly lower levels of SHBG (SMD=-0.48; 95% CI=-0.67, -0.28; Z=-4.77, P<0.0001) or adiponectin (SMD=-2.36; 95% CI=-3.39, -1.32; Z=-4.47, P<0.0001) and significantly higher concentrations of CRP (SMD=1.67; 95% CI=0.44, 2.90; Z=2.66, P=0.0079) in the first trimester than those women with normal pregnancies. These findings suggest that SHBG, adiponectin, and CRP may serve as first-trimester biomarkers for predicting the risk of developing GDM in pregnant women.